title: Effectiveness of public stroke educational interventions: a review.
abstract: OBJECTIVE
  Recognizing stroke symptoms and acting quickly can reduce death and disability, but public awareness of stroke risk factors, symptoms and what to do about them is still limited. Stroke educational campaigns are used worldwide but there are few published evaluations of such campaigns.
  
  
  METHODS
  The literature from 1999 to 2012 on the effectiveness of stroke educational campaigns was reviewed and summarized with narrative synthesis. Web-based campaigns were also described. Three databases and one search engine were explored with two keywords (stroke campaign and stroke promotion). The reference lists of all included articles were also examined.
  
  
  RESULTS
  Twenty-two intervention studies and five web-based campaigns were included in the review. Most interventions proved partially effective, in terms of gender preference (women) or type of information retained or media preferred. Only one intervention proved ineffective. Mass media campaigns can be effective but require sustained funding, and their ability to target high-risk subgroups, whether aging, linguistic or socioeconomic, is unclear. Three community-based participatory stroke promotion interventions proved partially effective, but the small sample sizes might have underpowered the results. Web-based campaigns are efficient in reaching a large number of people but tend to attract a selected and self-selected population.
  
  
  CONCLUSIONS
  Stroke educational campaigns have the potential to improve knowledge and awareness and change the behavior of a large number of people. Health promoters and investigators must adopt flexibility and participatory mentality to develop cost-effective interventions. Both community-based campaigns and E-tools should be integrated within a comprehensive multifaceted stroke promotion strategy to expand their reach.
authors.affiliation: UOS Stroke Unit, Azienda-Ospedaliera Sant'Andrea, Sapienza, University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rasura
authors.forename: M
authors.initials: M
authors.lastname: Baldereschi
authors.forename: A
authors.initials: A
authors.lastname: Di Carlo
authors.forename: F
authors.initials: F
authors.lastname: Di Lisi
authors.forename: R
authors.initials: R
authors.lastname: Patella
authors.forename: B
authors.initials: B
authors.lastname: Piccardi
authors.forename: B
authors.initials: B
authors.lastname: Polizzi
authors.forename: D
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*
keywords: stroke awareness; stroke education; stroke educational campaigns